The instant invention relates to a urological endoscopic device for the human body and more particularly to a ureteroscope for the operative management of the disease processes in the lower ureter under direct visual control.
It has been found that a variety of disease processes affect the lower ureter, particularly the last several centimeters of the ureter, in the area where it enters the urinary bladder. These disease processes include stones, tumors, and strictures and have heretofore been primarily treated with blind surgical devices which rely on X-ray and/or tactile control or with open surgery. While a number of urological endoscopic devices have heretofore been available, they have not been operative for providing direct visual control within the ureter, and hence they have not been entirely effective for treating disease processes within the ureter. Specifically, while the known endoscopic devices have included appliances which are adapted for operation within the ureter, they have not been operable for carrying out surgical procedures in the ureter under direct visual control. Common complications resulting from the use of such blind devices are uretal tear or rupture, as well as injury resulting from inadvertently impacted devices which in many instances has required surgery.
The instant invention provides a novel endoscopic device which is operable for carrying out procedures within the ureter under direct visual control. In this regard, the ureteroscope of the instant invention comprises a substantially straight, substantially rigid elongated sheath having distal and proximal ends, the sheath comprising an elongated main portion which is dimensioned for insertion into a patient so that it extends through the urethra and substantially through the bladder of the patient, a tapered portion which extends from the end of the main portion, and a reduced terminal portion which extends from the tapered portion and is dimensioned to be received in the ureter of a patient. A longitudinal telescope passage is provided extending through the sheath, and the ureteroscope further comprises a telescope assembly which is received in the passage to provide visual communication between the distal and proximal ends of the instrument. Accordingly, when the instrument is inserted into a patient so that the terminal portion of the instrument is received in the ureter of the patient, direct viewing of the ureter in the area thereof adjacent the distal end of the instrument is possible from the proximal end of the instrument through the telescope assembly. In the preferred embodiment of the instrument, irrigation passages are provided in the sheath for irrigating both the bladder and ureter areas of the patient. In one embodiment of the instrument, jaws are provided on the distal end of the sheath and are operable for carrying out various specific surgical functions within the ureter under direct visual control. In another embodiment of the instrument, a longitudinal appliance passage is provided in the sheath for receiving various appliances which are adapted for carrying out specific operative procedures within the ureter. One such appliance comprises a net assembly which functions in a purse-like manner for retrieving stones and the like from within the ureter. Another appliance comprises a dilating balloon assembly which includes a balloon which is inflatable to a barbell-like configuration so that it is operable for dilating the area of the ureter where it passes through the bladder wall. Specifically, the barbell-like balloon is positionable in a ureter so that opposite ends of the balloon are on opposite sides of the bladder wall. Thereafter the balloon can be inflated with the bladder wall positioned at the central portion of the barbell-like balloon so that the balloon does not tend to slip out of position and remains properly oriented in the ureter. Accordingly, it is seen that the ureteroscopic instrument of the instant invention is operable, in its various embodiments, for carrying out a variety of surgical procedures in the ureter under continuous direct visual control whereby the likelihood of success of a given procedure is maximized, and whereby complications and injury to the patient are minimized.
It is, therefore, a primary object of the instant invention to provide a ureteroscopic instrument which is operable for carrying out surgical procedures within the ureter under direct visual control.
Another object of the instant invention is to provide a purse-like surgical net which is operable for retrieving stones and the like from within the human body.
Another object of the instant invention is to provide an effective means for dilating the human ureter.
A still further object of the instant invention is to provide a urological endoscopic device which is operable for carrying out operative procedures within the ureter under direct visual control and which includes means for irrigating both the bladder and the ureter.
An even further object of the instant invention is to provide a urological endoscopic device whereby operative procedures can be carried out in the ureter with a relatively high likelihood of success and with minimal risk to a patient.
Other objects, features and advantages of the invention shall become apparent as the description thereof proceeds when considered in connection with the accompanying illustrative drawings.